Provider Demographics
NPI:1760359079
Name:MARIGOLD MOON COUNSELING, PLLC
Entity type:Organization
Organization Name:MARIGOLD MOON COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:DANDEKAR ROWAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:828-468-7250
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:MAIDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28650-0033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:204 E CARPENTER ST
Practice Address - Street 2:
Practice Address - City:MAIDEN
Practice Address - State:NC
Practice Address - Zip Code:28650-1608
Practice Address - Country:US
Practice Address - Phone:828-468-7250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty